A Review of a Study of Health Disparities in the United States

Article Abstract

Study objective:

Background: This study analyzed the disproportionate impact that the Covid-19 pandemic had on economically disadvantaged populations in the U.S. who were essential workers but unable to remain at home due to income needs [1].

Main ideas explored: This main focus of this study was the relationship between income and employment conditions with respect to the use of protective behaviors during the initial stage of the Covid-19 pandemic.

Study design and method: A self-administered survey advertised through a social media campaign collected data from 2,845 employed American adults in April 2020. The authors used a hierarchical generalized linear model approach to identify differences in the use of recommended protective practices based on income and employment status, controlling for the perceived threat of Covid-19 and worker knowledge.

Principal conclusions/results: Significantly higher percentages of essential workers experienced income loss and challenges using protective gear and behaviors in their workplace. Essential workers were less likely compared to non-essential workers to use conventional hygiene precautions such as wearing a mask and regularly washing their hands while at work.

Keywords: Pandemic, Covid-19, health disparities, hand hygiene

Introduction

Statement of the Problem: The impact of the Covid-19 pandemic has adversely affected American workers who occupy essential occupations but are paid disproportionately less than most non-essential workers. In addition, the working conditions of essential workers limits their ability to engage in protective behaviors and the use of protective gear.

Purpose of the Study; The overarching purpose of this study was to analyze the relationship between worker economic status and employment conditions with the use of protective behaviors during the beginning stage of the Covid-19 pandemic in order to confirm or refute the hypotheses below.

Hypotheses

The study was guided by two hypotheses as follows:

1. Hypothesis 1: Knowledge of recommended Covid-19 protective behaviors and Covid-19 threat perception are positively associated with engagement in such protective behaviors, such as frequent handwashing.

2. Hypothesis 2: Adoption of protective behaviors related to social distancing, such as staying at home, is determined by employment conditions. Specifically, from the perspective of the Health Belief Model (HBM), employment conditions impede self-efficacy to engaging in certain Covid-19 protective behaviors but not others.

Methodology

Methods: This was a quantitative study that used a social media platform for recruitment purposes.

Participants: A total of 2,845 working American adults completed the self-administered, online survey.

Data Collection Procedures: Participants completed the online survey in April 2020.

Data Analysis Procedures: The authors employed hierarchical generalized linear models to analyze the differences in...…with economic performance and stability than they are about the welfare of disadvantaged and undervalued Americans who do not enjoy the luxury of working from home or taking paid sick leave [2]. The methods used by the authors were described in sufficient detail to ensure their validity and reliability, and the findings that resulted during the initial phase of the Covid-19 pandemic provide valuable insights for policymakers and employers alike. In addition, given the nationwide lock-down status that was in effect when this study was conducted, its design was optimal with a high degree of applicability for community health practitioners.

What is especially noteworthy is the fact that these same lower-income workers are classified as essential; essentiality connotes importance but the pay levels of these workers do not reflect this. More troubling still, despite the significance of these findings and other studies in this area, nothing substantive has really been done to address them. This is a troubling outcome given the potential for yet another wave of a pandemic that has already claimed far more American lives than the Spanish flu epidemic in 1918, and seemingly infinite variants continue to emerge from around the world. It would seem that complacency and capitalism will prevail despite the urgency and importance of…